Anemik ve anemik olmayan kalp yetersizlikli hastalarda levosimendanın proinflamatuar sitokinler, beyin natriüretik peptit ve matriks metalloproteinaz-1 üzerine etkileri
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Tarih
2007
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info:eu-repo/semantics/openAccess
Özet
Dekompanse kalp yetersizlii tedavisinde, geleneksel tedaviye eklenen levosimendan tedavisinin, hemodinamik, klinik ve prognoz üzerine olumlu etkileri önceki çalmalarda gösterilmitir. Ayrca bu tedavi, kalp yetersizliinin özellikle son dönemlerinde kan düzeyleri artan proinflamatuar sitokinler, NT-proBNP ve MMP'lerin düzeylerini de azaltmaktadr. Kalp yetersizlii hastalarnda anemi, durumu kötületirici bir patolojidir. Ancak yaplan çalmalarda kalp yetersizlii hastalarnda anemi tedavisi konusunda bir görü birlii salanamamtr. Çalmamamzda, anemisi olan ve olmayan dekompanse kalp yetersizlii hastalarnda levosimendan tedavisinin etkinlii karlatrld. Bunun için 23 anemisi olan ve 23 anemisi olmayan dekompanse kalp yetersizlii hastasna, geleneksel kalp yetersizlii tedavisine eklenen levosimendan tedavisi, 24 saat süresince uyguland. Uygulama öncesi ve sonras, serum TNF-alfa, NTproBNP ve MMP-1 düzeyleri baklmak üzere kan örnekleri alnd. Sonuçta, anemisi olan ve olmayan hastalarda, tedavi öncesi ve sonras baklan TNF-alfa, NT-proBNP ve MMP- 1 düzeyleri arasnda anlaml fark izlenmedi. Her iki grupta, tedavi öncesi ve sonras deerler incelendiinde, TNF-alfa ve MMP-1 deerleri arasnda anlaml fark izlenmedi. Ancak NT-proBNP düzeyleri, her iki grupta da tedavi sonras, tedavi öncesine göre azald, ancak anlaml düzeye ulamad. Her iki grupta tedavi öncesi ve sonras fonsiyonel kapasitede anlaml düzelme görüldü. Bu çalmadan çkan sonuçlara göre levosimendan tedavisi, anemisi olan kalp yetersizlii hastalarnda, anemisi olmayan hastalardaki gibi benzer etki göstermektedir. Fonksiyonel kapasitede de belirgin iyileme salamaktadr. Anahtar Kelimeler: Dekompanse kalp yetersizlii, levosimendan, anemi, proinflamatuar sitokinler, matriks metalloproteinaz, natriüretik peptitler. s.
In the previous studies it was shown that, in the treatment of decompansated heart failure addition of levosimendan to traditional treatment has positive effects on hemodynamic parameters, clinical status and prognosis. Also this treatment decraeses the serum levels of proinflammatory markers, brain natriuretic peptide and matrix metalloproteinases which increases in the end stage of heart failure. Although anemia makes the situation worse in patients with heart failure, there is no consensus on the treatment of anemia in these patients. In our study, we compared the efficacy of levosimendan treatment in anemic and nonanemic patients with decompansated heart failure.Twenty three anemic and twenty three nonanemic patients with decompansated heart failure were treated with conventional heart failure treatment in which levosimendan infusion was added. Blood samples were taken for TNF-alpha, NT-proBNP and MMP-1 before and after levosimendan infusion. There was no significant difference in plasma TNF-alpha, NT-proBNP and MMP-1 levels were taken before and after levosimendan infusion. In both group NT-proBNP levels were lower after levosimendan treatment, but this did not reach statistically significance. Basides, there were improvoments in functional capacity. In conclusion, levosimendan treatment showed similar effects in anemic and nonanemic patients with heart failure and also yielded a significant improvement in functional capacity. Keywords: Decompansated heart failure, levosimendan, anemia, proinflammatory cytokines, matrix metalloproteinase, natriuretic peptide
In the previous studies it was shown that, in the treatment of decompansated heart failure addition of levosimendan to traditional treatment has positive effects on hemodynamic parameters, clinical status and prognosis. Also this treatment decraeses the serum levels of proinflammatory markers, brain natriuretic peptide and matrix metalloproteinases which increases in the end stage of heart failure. Although anemia makes the situation worse in patients with heart failure, there is no consensus on the treatment of anemia in these patients. In our study, we compared the efficacy of levosimendan treatment in anemic and nonanemic patients with decompansated heart failure.Twenty three anemic and twenty three nonanemic patients with decompansated heart failure were treated with conventional heart failure treatment in which levosimendan infusion was added. Blood samples were taken for TNF-alpha, NT-proBNP and MMP-1 before and after levosimendan infusion. There was no significant difference in plasma TNF-alpha, NT-proBNP and MMP-1 levels were taken before and after levosimendan infusion. In both group NT-proBNP levels were lower after levosimendan treatment, but this did not reach statistically significance. Basides, there were improvoments in functional capacity. In conclusion, levosimendan treatment showed similar effects in anemic and nonanemic patients with heart failure and also yielded a significant improvement in functional capacity. Keywords: Decompansated heart failure, levosimendan, anemia, proinflammatory cytokines, matrix metalloproteinase, natriuretic peptide
Açıklama
Anahtar Kelimeler
Kardiyoloji, Cardiology
